Saripalli Shirisha, Suliman Hiba, Haseeb Hafiz, Nawaz Faisal, Khan Huda
Medicine, Grange University Hospital, Cwmbran, GBR.
Gastroenterology and Hepatology, Royal Albert Edward Hospital, Wigan, GBR.
Cureus. 2025 Apr 15;17(4):e82296. doi: 10.7759/cureus.82296. eCollection 2025 Apr.
A 75-year-old male patient was admitted with a two-week history of melena on a background of psoriatic arthritis and chronic iron-deficiency anaemia. Initial bloods confirmed acute-on-chronic anaemia with evidence of ongoing bleeding as the hemoglobin consistently dropped to 77g/L from 84g/L. After resuscitation which included giving a unit of blood transfusion, an urgent endoscopy revealed moderate gastric fundal vascular ectasia (GFVE) with active bleeding from three points and mild gastric antral vascular ectasia with no bleeding. Pulsed Argon-Plasma coagulation was successfully applied during endoscopy immediately, achieving haemostasis. Small Grade-2 oesophageal varices without bleeding were also noted. Subsequent imaging confirmed new liver cirrhosis with CHILD-PUGH scoring of 6 falling into category A, which was under investigation as outpatient. The patient's haemoglobin stabilized post-endotherapy with significant symptoms improvement and he was also given intravenous iron infusion. No further gastrointestinal bleeding event was noted until the writing of this article.
一名75岁男性患者因有两周黑便病史入院，其基础疾病为银屑病关节炎和慢性缺铁性贫血。初步血液检查证实为慢性贫血急性加重，有持续出血迹象，血红蛋白从84g/L持续降至77g/L。在进行包括输注一个单位血液的复苏治疗后，紧急内镜检查显示中度胃底血管扩张（GFVE），有三点活动性出血，轻度胃窦血管扩张但无出血。在内镜检查期间立即成功应用了脉冲氩离子凝固术实现止血。还发现了无出血的小的2级食管静脉曲张。随后的影像学检查证实为新的肝硬化，Child-Pugh评分为6分，属于A类，正在作为门诊患者进行调查。患者血红蛋白在内镜治疗后稳定，症状明显改善，还接受了静脉补铁治疗。在撰写本文时未再发现进一步的胃肠道出血事件。
